A 12-month follow-up study of “RedUSe”: a trial aimed at reducing antipsychotic and benzodiazepine use in nursing homes

2011 ◽  
Vol 23 (8) ◽  
pp. 1260-1269 ◽  
Author(s):  
Juanita Westbury ◽  
Lisette Tichelaar ◽  
Gregory Peterson ◽  
Peter Gee ◽  
Shane Jackson
Keyword(s):  
Nursing Homes ◽  
Controlled Trial ◽  
Study Data ◽  
Follow Up Study ◽  
Benzodiazepine Use ◽  
The Mean ◽  
Long Term Impact ◽  
Dose Reductions

ABSTRACTBackground: To assess the long-term impact of the “Reducing Use of Sedatives” (RedUSe) trial on antipsychotic and benzodiazepine prevalence and dosage.Methods: RedUSe was a six-month controlled trial conducted in 25 Tasmanian nursing homes in 2008–9 which led to significant reductions in benzodiazepine and antipsychotic use and a doubling of dose reductions of these agents. In a follow-up study, data on psychotropic use was collected from all nursing homes a year after the final RedUSe measure. Mean daily doses for each home were calculated by converting antipsychotic and benzodiazepine doses to chlorpromazine and diazepam equivalents, respectively. To determine the long-term impact of the project, 6-month and initial baseline data were compared to the 18-month follow-up data.Results: 1578 residents were audited for the follow-up measure. In the 18 months since the RedUSe project was instigated, benzodiazepine prevalence fell by 25% in intervention nursing homes. Similarly, the mean daily diazepam equivalence in these homes had fallen by 24%. In contrast, after a significant reduction during the RedUSe trial, antipsychotic prevalence returned to baseline levels in intervention nursing homes, with mean chlorpromazine equivalence remaining relatively constant with time. There was a delayed reduction in benzodiazepine and antipsychotic use in the control homes.Conclusions: Both benzodiazepine usage and mean daily diazepam equivalence continued to decline in intervention nursing homes in the year following the RedUSe trial. However, the effect of the RedUSe intervention on antipsychotic prevalence and dosage was not sustained.

scholarly journals Long-Term Follow-Up of a Randomized Controlled Trial to Reduce Excessive Weight Gain in Infancy: Protocol for the Prevention of Overweight in Infancy (POI) Follow-Up Study at 11 Years (Preprint)

2020 ◽  
Author(s):  
Taiwo O Adebowale ◽  
Barry J Taylor ◽  
Andrew R Gray ◽  
Barbara C Galland ◽  
Anne-Louise M Heath ◽  
...  
Keyword(s):  
Mental Health ◽  
Physical Activity ◽  
Controlled Trial ◽  
Electronic Media ◽  
Health And Wellbeing ◽  
Validated Questionnaires ◽  
Follow Up Study ◽  
Randomized Controlled

BACKGROUND The Prevention of Overweight in Infancy (POI) randomized controlled trial assessed the effect of a more conventional food, physical activity, and breastfeeding intervention, with a more novel sleep intervention on weight outcomes at 2 years of age. The trial had 58% uptake at recruitment, and retention was 86% at age 2 years, 77% at age 3.5 years, and 69% at age 5 years. Children who received the brief sleep intervention in infancy had just half the risk of obesity at 2 years of age compared to those who did not receive the sleep intervention. Importantly, this substantially reduced risk was still apparent at our follow-up at 5 years of age. OBJECTIVE The primary aim of this follow-up at age 11 years is to determine whether differences in BMI z-score and obesity risk remain apparent now that it is at least 9 years since cessation of the sleep intervention. Several secondary outcomes of interest will also be examined including 24-hour movement patterns, mental health and wellbeing, and use of electronic media, particularly prior to sleep. METHODS We will seek renewed consent from all 734 of the original 802 POI families who expressed interest in further involvement. Children and parent(s) will attend 2 clinics and 1 home appointment to obtain measures of anthropometry and body composition (dual-energy x-ray absorptiometry scan), 24-hour movement patterns (sleep, sedentary time, and physical activity measured using an AX3 accelerometer), mental health and wellbeing (validated questionnaires), family functioning (validated questionnaires), use of electronic media (wearable and stationary cameras, questionnaires), and diet and eating behaviors (24-hour recall, questionnaires). RESULTS This follow-up study has full ethical approval from the University of Otago Human Ethics Committee (H19/109) and was funded in May 2019 by the Health Research Council of New Zealand (grant 19/346). Data collection commenced in June 2020, and first results are expected to be submitted for publication in 2022. CONCLUSIONS Long-term outcomes of early obesity intervention are rare. Despite the growing body of evidence linking insufficient sleep with an increased risk of obesity in children, interventions targeting improvements in sleep have been insufficiently explored. Our initial follow-up at 5 years of age suggested that an early sleep intervention may have long-term benefits for effective weight management in children. Further analysis in our now preteen population will provide much-needed evidence regarding the long-term effectiveness of sleep interventions in infancy as an obesity prevention approach. CLINICALTRIAL ClinicalTrials.gov NCT00892983; https://tinyurl.com/y3xepvxf INTERNATIONAL REGISTERED REPORT DERR1-10.2196/24968

scholarly journals The Effects of If-Then Plans on Weight Loss: Results of the 24-Month Follow-up of the McGill CHIP Healthy Weight Program Randomized Controlled Trial

2019 ◽  
Author(s):  
Barbel Knauper ◽  
huma shireen ◽  
Kimberly Carriere ◽  
Mallory Frayn ◽  
Elena Ivanova ◽  
...  
Keyword(s):  
Weight Loss ◽  
Controlled Trial ◽  
Diabetes Prevention Program ◽  
Weight Loss Maintenance ◽  
Study Data ◽  
Average Weight ◽  
Healthy Weight ◽  
Clinically Significant

Abstract Background: The NIH-developed Diabetes Prevention Program (DPP) is successful in achieving clinically significant weight loss in individuals with overweight/obesity when delivered one-on-one. However, due to high cost of implementation, the long-term effectiveness remains limited. In response, a group-based version of the program, called the National DPP, was developed. The average weight loss following participation in this program was only about 3.5% with low long-term weight loss maintenance. Purpose: We aimed to optimize weight loss outcomes of the National DPP by integrating the habit formation tool of if-then plans into the program. Results at 3 and 12 months of participation showed no between-group differences between standard and enhanced DPP but higher weight loss in both groups compared to the National DPP. This paper reports the long-term weight loss maintenance data following participation in the program. Methods: Of the 172 participants enrolled at the beginning of the study, data from 110 participants was available and analyzed at 24 months, i.e. 12 months following the end of the 12-month intervention. Results: No between-group difference in weight loss maintenance was seen. Pooled results showed a significant weight regain from 12 to 24 months, i.e. an average of 7.85lbs of the 20.36lbs lost. However, participants from both groups were still 12.51lbs or 6.13% lighter at 24 months than at baseline. Conclusion: If-then plans did not result in a higher percentage of weight loss at 24-month follow-up. However, at 24 months, both groups maintained a significant portion of the weight lost at the end of intervention.

scholarly journals Immunoglobulins in Neonates with Rhesus Hemolytic Disease of the Fetus and Newborn: Long-Term Outcome in a Randomized Trial

2015 ◽  
Vol 39 (3) ◽  
pp. 209-213 ◽  
Author(s):  
Jeanine M.M. van Klink ◽  
Suzanne J. van Veen ◽  
Vivianne E.H.J. Smits-Wintjens ◽  
Irene T.M. Lindenburg ◽  
Monique Rijken ◽  
...  
Keyword(s):  
Randomized Controlled Trial ◽  
Placebo Group ◽  
Controlled Trial ◽  
Neurodevelopmental Outcome ◽  
Hemolytic Disease ◽  
Follow Up Study ◽  
Randomized Controlled ◽  
Neurodevelopmental Impairment

Objective: Prophylactic intravenous immunoglobulin (IVIg) does neither reduce the need for exchange transfusion nor the rates of other adverse neonatal outcomes in neonates with rhesus hemolytic disease of the fetus and newborn (rhesus HDFN) according to our randomized controlled trial analysis. Our objective was to assess the long-term neurodevelopmental outcome in the children included in the trial and treated with either IVIg or placebo. Methods: All families of the children included in the trial were asked to participate in this follow-up study. The long-term neurodevelopmental outcome in children at least 2 years of age was assessed using standardized tests. The primary outcome was the incidence of neurodevelopmental impairment defined as at least one of the following: cerebral palsy, severe cognitive and/or motor developmental delay (with a test score of less than -2 SD), bilateral deafness or blindness. Results: Sixty-six of the 80 children (82.5%) who had been recruited to the initial randomized controlled trial participated in the follow-up study. The children were assessed at a median age of 4 years (range 2-7). The median cognitive score was 96 (range 68-118) in the IVIg group and 97 (range 66-118) in the placebo group (p = 0.79). There was no difference in the rate of neurodevelopmental impairment between the IVIg and the placebo group [3% (1/34) vs. 3% (1/32); p = 1.00]. Conclusions: The long-term neurodevelopmental outcome in children treated with IVIg was not different from that in children treated with placebo. Standardized long-term follow-up studies with large enough case series and sufficient power are needed to replicate these findings.

Vitamin–Mineral Treatment of ADHD in Adults

2016 ◽  
Vol 21 (6) ◽  
pp. 522-532 ◽  
Author(s):  
Julia J. Rucklidge ◽  
Chris M. Frampton ◽  
Brigette Gorman ◽  
Anna Boggis
Keyword(s):  
Controlled Trial ◽  
Small Sample ◽  
Self Report ◽  
End Of Treatment ◽  
Significant Regression ◽  
Long Term Impact ◽  
Dominant Treatment ◽  
Better Than

Objective: Despite widespread use, there is little data investigating the long-term impact of micronutrients on psychiatric disorders. This study investigated the naturalistic outcome 1-year post-baseline of a randomized controlled trials (RCT) that compared micronutrients with placebo in 80 adults with ADHD. Method: All participants were contacted and clinician-rated questionnaires completed. Results: A total of 72 (90%) of the sample participated; although there was significant regression in psychiatric functioning from the end-of-trial on all measures, outcomes remained significantly improved from baseline. Dominant treatment from the end-of-treatment to follow-up was investigated as a mediator of outcome; those staying on the micronutrients performed better than those who switched to medications or discontinued micronutrients. Cost was the most substantial reason why people stopped micronutrient treatment. Conclusion: For the small number of participants who stayed on micronutrients, the benefits conferred through the controlled trial were maintained. The results are limited by small sample, lack of blinding, expectation, and reliance on self-report of symptoms.

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